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Personality Disorders and Substance Abuse

According to the experts at the National Institute on Drug Abuse, it is not uncommon for an individual who suffers from addiction or substance abuse to also suffer from a co-occurring disorder. One group of disorders that may be present in Dual Diagnoses cases with addiction are personality disorders. These types of disorders have different manifestations and symptoms which can alter how a person views the world around them. When placed in conjunction with a substance abuse issue, it is important to understand what the disorder is and how to treat it at the same time as treatment for drug addiction occurs.

Types of Personality Disorders

The Mayo Clinic lists three different types of personality disorders known as “clusters.”  There is a variety of personality disorders listed in each category. The first cluster consists of paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder.

  • An individual who is worried that people are “out to get them” or who has a fear that people in their life have ulterior motives against them may suffer from paranoid personality disorder, while someone who is unable to feel pleasure, is emotionally unattached or who has limited social skills may be affected by schizoid personality disorder.
  • The final type of personality disorder in this first category, schizotypal personality disorder, manifests symptoms such as an odd appearance and behaviors, fantasies, or a tendency to display feelings in an inappropriate manner.

The second group of personality disorders consists of antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder.

  • Antisocial personality disorder was previously known as sociopathic personality disorder and consists of symptoms such as a disregard for the well-being of others, lying and/or stealing as well as aggression or violent behavior patterns.
  • Borderline personality disorder is characterized by risky behaviors, mood issues, suicide attempts, and an inability to maintain healthy relationships.
  • When an individual is unable to control their emotions, together with a need to have attention focused on them and needed others’ approval, they may suffer from histrionic personality disorder.
  • Narcissism is the feeling that one is better than their peers, coupled with fantasies of power, exaggerating one’s accomplishments, and needing to be praised for those accomplishments, whether real or imagined.

The final collection of personality disorders recognized by the medical community includes disorders that may cause anxiety or fear, including avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder.

  • People who are diagnosed with avoidant personality disorder tend to avoid social situations due to shyness or feelings that they aren’t good enough to socialize with certain individuals.
  • Those suffering from dependent personality disorder may have symptoms exactly opposite avoidance personality disorder in that they cleave to others despite the presence of abuse or mistreatment, while exhibiting submissive behaviors.
  • Obsessive-compulsive personality disorder, while it shares some traits with obsessive-compulsive disorder, is not the same condition. Individuals suffering from the personality disorder take perfectionism in their tasks to an even higher degree, and they may also exhibit signs of hoarding, or the inability to throw away items such as garbage, old food, or other items with no purpose or value.

The causes of these types of personality disorders is not well understood by researchers; however, they are directly linked to an increased likelihood of substance abuse issues either directly or due to the presence of other complications, including depression or anxiety.

Personality Disorders and Substance Abuse

One of the most concerning disorders as it relates to an increased risk of substance abuse is antisocial personality disorder, according to the United States Department of Justice. An individual who suffers from this disorder has a 15-percent higher risk of abusing drugs than someone who does not suffer from the condition, for instance.

Anytime we are faced with something as tragic as mental illness, particularly when it manifests in addiction to drugs or alcohol, it is only natural to ask ourselves why. Why did we, or someone we love, develop this mental disorder?  Did we develop the mental disorder first, or was it caused by the abuse of drugs or alcohol?  Unfortunately, there is no guarantee that these types of questions can be answered. There is good news, however. These conditions, while chronic in nature, can respond to treatment.

Treatment for Substance Abuse in a Dual Diagnosis

personality disorders and substance abuseOne of the most accepted forms of treatment for substance abuse disorders is the use of Cognitive Behavioral Therapy. This unique style of psychotherapy is very different from the “talk therapy” of the past. Prior to the development of this type of program, an individual might visit their therapist once a week or once a month for years, talking about their lives, their issues as the therapist offered advice and, in some cases, medication to alleviate symptoms. Cognitive Behavioral Therapy is far more practical and “hands on.”  For instance, in CBT, the patient and the therapist are partners in the recovery process.

Together, they will delve into specific examples of real-life circumstances, examine how the recovering individual’s thought processes might handle the events, and develop the coping skills needed to make informed, healthy decisions about future behaviors. The process involves homework, intensive focus on the issues at hand, as well as practical accountability. The final difference is in the time it takes to complete a course of CBT, compared to the open-ended talk therapy model. Cognitive Behavior Therapy is generally no more than 16 weeks, according to the National Association of Cognitive Behavioral Therapists.

A study published in 2010 found that CBT is also a useful tool in addressing a wide range of personality disorders as well. In the study, the researches allowed that more studies should be conducted; however, they found that many of the same principles that make CBT good for addiction work well for personality disorders, such as the idea that individuals with personality disorders often have a skewed thought process on an automatic level and are not skilled in analyzing the real meanings behind various situations.

When an individual suffers from both substance abuse and a personality disorder at the same time, it is imperative that both issues are addressed at the same time. If one is treated, for instance the substance abuse, without properly treating the personality disorder, the reasons for the drug abuse may remain steadfastly in place, jeopardizing recovery before it has even properly begun.

How to Find a Drug Rehab That Focuses on Dual Diagnosis Cases

There are many different types of drug treatment centers that offer services for people who find themselves addicted to drugs or alcohol. However, only a treatment center that actively provides treatment for a Dual Diagnosis condition will have the expertise and experience necessary to provide the kind of care you, or a beloved family member, needs. There are a few questions you can ask a prospective treatment center to find out if they are capable of providing the compassionate level of care your family requires.

  1. Does the treatment center provide an assessment to determine whether any previously undiagnosed conditions exist prior to developing a treatment program?In some cases, an individual may be self-medicating to the point that their personality disorder has not been recognized. One may have assumed that their behavior has been a result of substance abuse, rather than a separate and unique condition that needs treatment of its own.
  2. Will the treatment program create a unique and personal treatment program based on the needs of your family?
    The National Institute on Drug Abuse has found that the most effective treatment plans are those that will create a plan to meet the needs of the individual, tailoring the aspects of the plan and goals for recovering to match the circumstances in the individual’s current and past experience. The plan should also be flexible enough to change as the individual’s circumstances change, and it should be of a sufficient duration. Treatment may last beyond a residential stay, for instance, and some individuals will find they are ready to begin outpatient follow-up care more quickly than others.
  3. Does the treatment program offer follow-up or continuing care?Having the fellowship of others in recovery and actively participating in sober living activities can help individuals find the benefits of remaining drug- or alcohol-free. Studies have shown that individuals who choose to live in these types of environments, such a sober living homes, tend to participate more actively in their own recovery by focusing on their goals and day-to-day experiences.

Turning to drugs or alcohol to assuage feelings is a dangerous and unrewarding way to live, and it is not necessary when there are so many treatment options available. If you are concerned that someone you love may be suffering from a personality disorder in addition to an addiction to drugs or alcohol, please contact us here at The Canyon for information about the treatment options available to you and your family.